脉∶痈疽脉数,浮阳沉阴。浮数不热,但恶寒侵。若知痛处,急灸或针。洪数病进,将有脓淫。
滑实紧促,内消可禁。宜托里者,脉虚濡迟。或芤涩微,溃后亦宜。长缓易治,短散则危。结促
代见,必死无疑。
疮疡之症,当察经之传受,病之表里,人之虚实而攻补之。假如肿痛热渴、大便闭结者,邪在内
也,疏通之。肿 作痛、寒热头疼者,邪在表也,宜发散之。 肿痛甚者,邪在经络也,和解之。
微肿微痛而不作脓者,气血虚也,补托之。漫肿不痛、或不作脓、或脓成不溃者,血气虚甚也,峻补
之。色黯而微肿痛、或脓成不出、或腐肉不溃者,阳气虚寒也,温补之。若疑其未溃,而概用败毒,
复损脾胃,不唯肿者,不能成脓而溃者,亦难收敛,七恶之症蜂起,多致不救。经云∶诸痛痒疮疡,
皆属心火。若肿赤烦躁、发热引冷、便闭作渴、脉洪数实,是其常也。虽在严寒之时,必用大苦
寒之剂,以泻热毒。若脉微皮寒、泻痢肠鸣、饮食不入、呕吐无时、手足逆冷,是变常也。虽在盛暑
之时,必用大辛温之剂,以助阳气。经曰∶用寒远寒,用热远热。有假者反之,虽违其时,必从其症。
痈疽,大按乃痛者,病深;小按便痛者,病浅。按之处陷不复者,无脓;按之处即复者,有脓。
不复者可消。若按之都牵强者,未有脓也;按之半软者,有脓也。又手按上下不热者无脓;若热甚
者有脓。凡觉有脓,急当破之。无脓但气肿,若有血,慎之慎之!不可针破也。
痈者,大而高起属乎阳,六腑之气所生也。疽者,平而内发属乎阴,五脏之气所成也。
凡痈疽未破,毒攻脏腑,一毫热药不敢用。若已溃破,脏腑既亏,饮食少进,一毫冷药不敢用也。
肿疡者,痈疽未见脓而肿也。肿疡内外皆壅,宜以散毒表散为主。设欲行大黄者,宜审其虚寒之原。
痈疽初起之时宜
灸法 治痈疽发背初生,累试累效。凡人初觉痈疽发背、已结未结、赤热肿痛,先以湿纸覆其
上,立视,候其纸先干处即是结疽头处。取大蒜切成片,如三个铜钱浓,安在头上,用火艾壮灸之三壮,
换一蒜片。痛者,灸至不痛;不痛者,灸至痛时方住。最要早觉早灸为上;方发一二日者,十灸十
愈;三四日者,六七愈;五六日者,三四愈;过七日,则不可灸矣。若有十数头作一处生者,用大蒜捣
成膏作饼子,铺疮头上,聚艾烧之,亦能安也。若背上初发赤肿,内有一粒,黄如粟米者,即用独蒜切
片如前灸法治之,次日去痂,脓自溃也。
竹筒吸毒方 诸般恶疮并治。
用苦竹长一二寸,用头节妙,刮去青皮,似纸薄为佳,其大小随疮斟酌,应毒疮初发时用∶
白蒺藜 苍术 乌 皮 白浓朴(各五钱重)
上四味锉片,用水一碗,同煎竹筒,煎煮以药将干为度。
乘竹筒热,以手按之于疮上,顷之,其筒自粘在疮上,不必手按也。仍更用前药分两再煮,候前竹筒冷,
以手拔去,再换热者,如前法,其脓自吸入筒中而愈。
荆芥败毒散 治痈疽疔肿、发背乳痈等症,憎寒壮热,甚者头痛拘急,状似伤寒,一二日至四五
日者,一二剂散其毒。轻者,内自消散。
防风 荆芥 羌活 独活 柴胡 前胡 薄荷 连翘 桔梗 枳壳 川芎 茯苓 金银花 甘草 大便
不通加大黄、芒硝,热甚痛急加黄芩、黄连。
上锉,生姜煎服。疮在上,食后服;在下,食前服。
千金漏芦汤 治一切恶疮肿毒、丹瘤瘰疡、疔肿鱼睛、五发瘭疽。初起一二日,便如伤寒,头痛
烦渴、拘急恶寒、肢体疼痛、四肢沉重、恍惚闷乱、坐卧不宁、皮肤壮热、大便闭结、小便赤黄并治。妊妇
勿用。
漏芦 白蔹 黄芩 麻黄 枳实(麸炒) 升麻 芍药 甘草(炙) 大黄 芒硝 连翘。
上锉作剂,水煎服。
追风通气散 治痈疽发背、脑疽流注、肿毒、救坏病、活死肌,弭患于未萌之前,拔根于既愈之后。
此药顺气匀血,扶植胃本,不伤元气,涤荡邪秽,自然通顺,不生变症,兼治打破伤折、疝气血疝香港脚、诸气
痞塞、块痛腰痛,一切痰饮为患。
当归 何首乌(不犯铁器) 木通(去皮节) 赤芍 白芷 乌药 小茴香 枳壳(麸炒) 甘草
上锉剂,酒、水各煎。病在上,食后服;在下,食前服。
一、痈疽初萌,必气血凝滞所成,为日既久,则血积于所,滞而后盛作,故病患气血盛者减当归,多则
生血,发于他所再结痈毒,生生不绝矣。
一、痈疽发背在上者,去木通,恐导虚下元,为上盛下虚之病,难于用药。
一、痈疽生痰有二∶一胃寒生痰,加半夏健脾化痰;二乃郁而成风痰,加桔梗、生姜。
一、流注,可加独活。流注者,气血凝滞,故气滞则血留而凝。加独活者,可以动一身血脉,血脉既动,
岂复有流注乎?(一方以醋湿纸贴痛处,以炒盐熨之即消。)
一、流注起于伤寒,伤寒表未尽,遗毒于四肢经络,涩于所滞而后为流注也。如病尚有潮热,则里有寒
而未尽散,加升麻、苏叶;热不退、加干葛;头痛加川芎、姜、葱;无汗用酒、水各半煎,大能行血生气故也。
一、发背既久不愈,乃前医用凉药过也。凉药内伤其脾,外冰其血。脾主肌肉,脾既受伤,饮食必减,
颜色痿瘁,肌肉不生;血为脉络,血一受冰,则气不旺,肌肉糜烂。故必理脾,脾健肉自生。本方去木通,
少用当归,加浓朴、陈皮;盛则加白豆蔻。
一、凡病痈疽之人,有泄泻者,不可便服此药。宜先服蜡矾丸止泻,后用此。
一、肠肚内痈,宜十宣散与此方相间服之,并宜加忍冬藤。
一、肿毒坚硬不穿加川芎、独活、麻黄、连须葱煎服,出汗即穿。
一、伤折在头上去木通,加川芎、陈皮。
一、经年腰痛加萆 、玄胡索,酒煎。
一香港脚加木瓜、槟榔、穿山甲、水煎。
一痰饮为患,或喘或咳或晕、头痛睛疼、遍身拘急、骨节痹疼、胸背头项腋胯腰腿手足聚结肿硬,
或痛或不痛,按之无血潮,虽或有微红亦淡薄不热;坚如石,破之无脓,或有薄血、或清水、或乳汁;
又有坏肉如破絮;或又如瘰 在皮肉之间如鸡卵,可移动,软活不硬,破之亦无脓血,针口 肉突出,
唯觉咽喉痰实结塞,作寒作热加南星、半夏。
神功散 治痈疽发背、一切疔毒并瘰 等症,已成未成患者神效。
川乌(泡去皮尖) 川黄柏(炙去粗皮,各等分)
上为细末,用唾调成膏。如唾少,漱口水亦可,发背痈疽等疮才起者,敷患处留顶。候药干,
用淘米水时常润湿。每日药敷一次。如疮已成重患将溃烂者,先将槐枝、艾叶煎汤顿温,将疮洗
净,用绢帛展去脓血,以香油润患处,用绵纸仍照患处剪成圆钱留顶粘贴,后用药涂于纸,如干,
根据前用淘米水润。日换一次,听其自然流脓,不可手挤。如敷药后,病患疮觉住痛,减热即愈。
如生肌,则腐肉自落。腐如不落者,剪割亦可,最不宜用针。发背不宜贴膏药。凡医疮,屏去别医,
止饮别药方可治。忌气怒、房事、劳复并孝服体气,饮酒之人,饮食忌酒,并鸡、羊、鱼、肉、瓜
茄、姜辣之物。若因气怒,再复发肿,根据前治之。如治对口并脑疽,不必洗去旧药,逐次添药,
恐动疮口惹风也。一肿毒加南星、赤小豆等分,醋调涂即消,姜汁亦可。
真人夺命饮 治一切痈疽疔肿,不问阴阳虚实善恶,肿溃大痛或不痛。然当服于未溃之先与
初溃之际。如毒已失溃不可服。仍用一剂,大势已退,然后随症调治,其功甚捷,诚仙方也。
穿山甲(三大片,切,蛤粉炒成珠) 天花粉 甘草节 乳香(明透者) 赤芍 白芷(各一钱)
防风 贝母(各七分) 没药 皂角刺(各五分,炒) 陈皮(一钱半) 归尾(一钱半) 金银花(二钱)
上锉一剂,好酒煎,空心、热服。能饮者,服后再饮酒三五杯,滓再煎服。在背俞,倍皂角刺;在腹膜,
倍白芷;在胸次,加栝蒌仁(二钱);在四肢,倍金银花。
吕洞宾仙传化毒汤 治痈疽、发背、乳痈、一切无名肿毒。初起服之立消。已成已溃服之立愈。
防风 甘草节 白芷 茯苓 贝母 黄芩 连翘 白芍(各一钱) 天花粉 金银花(各一钱二分)
半夏(七分) 乳香 没药(各五分)
上锉一剂,好酒煎。胸前,饭前服;背上,饭后服;下部,空心;上部;食后。俱要出汗为度。如无汗,
用木香熏脚膝腕内,被盖汗出而愈。
神仙排脓散 治恶疮毒、风毒、疔疮、背花疮、小儿恶疮,脓血俱从大便中出。亦治气滞腹胀及妇
人经闭不通。此方,壮实之人可用,虚弱者当忌之矣。
大黄(十二两,酒浸一宿晒干) 白芷 沉香 木香 乳香 没药 穿山甲(陈壁土炒。各五钱)
上各为细末,量人虚实用之。实者不过三钱,虚者二钱半。临卧,用好生酒调服。服后,禁饮食汤
水半日。五更觉腹内疼痛,动三五次,以稀米粥补之。服此药内有穿山甲,恐令人作呕,须慎之,即嚼生
葱可止。凡修合此药要诚意,不可令妇人、鸡犬见,又不可多合,恐久放则不效矣。
芙蓉膏 治痈疽发背诸毒。
芙蓉叶(或皮或根亦可) 黄荆子
上各等分,入石臼内捣极烂,用鸡子清调,搽于疮上留
顶,不过二次收功。顶如烟起,立时止痛。其效如神。
一方 治发背痈疽,不问已溃未溃,敷上立消,止痛如神。
白金凤花科,连根叶同捣烂。先用陈米醋洗净患处,后敷药,一日一换。疮将好,用桑叶醋煮一滚
即捞起贴疮上,即生肌收口而愈。
溃疡者,痈疽之脓已溃出也。疡溃,内外皆虚,宜以补接为主。设欲行香散者,宜防其虚实之失。
由是言之,则痈疽之肿时与溃时不同。
痈疽已溃之后,宜后方。(李氏云∶疽疾将安,每日当服十全大补汤以补气血,宜与千金内托散相间服。)
托里消毒饮 治一切痈疽六七日未消者。服此药,疮未成即消,已成即溃,能壮气血、固脾胃,
使毒瓦斯不能内攻,使毒脓易溃、肌肉易生。切不可早用生肌之药,恐毒未尽反溃烂难愈。
金银花(三钱) 黄 (蜜水炒) 天花粉(各二钱) 防风 当归(酒洗) 川芎 白芷
浓朴(姜汁炒) 桔梗 穿山甲(炒成珠) 皂角刺(炒。各一钱) 陈皮(三钱)
上锉一剂,酒、水各一盏煎服。疮在上,食后服;在下,空心服。后用水煎服。
千金内托散 治痈疽疮疖,未成者速败,已成者速溃,脓自去,不用手挤;恶肉自去,不用刀针。
服药后,疼痛顿解,此药活血匀气,调胃补虚、祛风邪、辟秽气,乃王道之剂。宜多服之大效。
黄 (蜜炙) 人参 当归(酒洗各二钱) 川芎 防风 桔梗 白芷 浓朴(姜汁炒) 薄荷
甘草(生用。各一钱) 加金银花亦可。
上为细末,每服二钱,黄酒调下。不饮酒,木香汤调下
亦可。或都作一剂,用酒煎尤佳。痈疽肿痛,倍白芷;不肿痛,倍官桂,不进饮食加砂仁、香附;
痛甚加乳香、没药;水不干加知母、贝母;疮不穿、加皂角刺;咳加半夏、陈皮、杏仁、生姜五片;
大便闭加大黄、枳壳;小便涩加麦门冬、车前子、木通、灯草。
十全大补汤 治痈疽溃后,补气血、进饮食,实为切要。凡脓血出多,阴阳两虚,此药有
回生起死之功。但不分经络,不载时令,医者触类而长之可也。或见肿平痛宽,遂以为安。
慢不知者无补调养之功,愈后虚证复见,因而转为他病而危剧者多矣。
神仙蜡矾丸 治痈疽及肺痈、肠痈,能消毒、固脏腑、止疼痛、护脂膜、止泻漏,化脓痈疽
溃后宜。兼治诸疮毒、粉瘤、痰核,三五年者,半料即消。不问恶疮新起者亦效。
黄蜡(二两) 白矾(三两)
上为末,熔蜡为丸,如梧桐子大。每服三十九,酒下。不饮酒,熟水下。一日服三次。肺痈,蜜汤下。
咳嗽,姜汤下。
五善七恶主治∶夫善者,动息自宁,饮食知味、便利调匀、脓溃肿消、水鲜不臭、神彩精明、
语声清朗、体气和平是也。此属腑症,病微邪浅,更能慎起居、节饮食,勿药自愈。恶者,乃五脏亏损
之症。或因汗下失宜,荣卫消灼;或因寒凉克伐,气血不足,或因峻厉之剂,胃气受伤,以致真
气虚而邪气实,外似有余而内实不足。法当纯补胃气,多有可生。不可因其恶遂弃而不治。
若大渴发热,或泻泄淋闭者,邪火内淫,一恶也。(竹叶黄 汤。气血俱虚,八珠汤加黄 、
麦门冬、五味子、山茱萸,如不应,佐以加减八味丸同服)
若脓血既泄,肿痛尤甚,脓色败臭者,胃气虚而火盛,二恶也。(人参黄 汤。)如不应,
用十全大补汤加麦门、五味。)
若目视不正、黑睛紧小、白睛青赤、瞳子上视者,肝肾阴虚而目系急,三恶也。
(六味丸加炒山栀、麦冬、五味子。如不应,用八珍汤加炒山栀、麦冬、五味子。)
若喘粗气短、恍惚嗜卧者,脾肺虚火,四恶也。(六君子加大枣、生姜。如不应,用补中益
脉象:痈疽的脉象若为数脉,浮取属阳,沉取属阴。若脉浮数但体表不热,只是感到恶寒侵袭。若能确定疼痛的具体部位,应立即采用艾灸或针刺治疗。若脉象洪大且数,说明病情进展,即将化脓流溢。
若脉象滑、实、紧、促,说明邪气内结,可通过内服药物消散。若适宜使用托里透脓法,则脉象应表现为虚、濡、迟。或者出现芤、涩、微弱的脉象,在疮疡溃破后也适宜使用托里法。脉象长而缓者易治,脉象短而散乱者则危险。若出现结脉、促脉、代脉,必定死亡无疑。
疮疡病症,应当观察经络的传变,病位的表里,以及患者体质的虚实,从而决定攻邪或补虚。例如,出现肿痛、发热、口渴、大便闭结等症状,是邪气在体内,应当疏通排泄。若肿胀作痛、伴有寒热头痛,是邪气在体表,应当发散解表。若肿痛剧烈,是邪气在经络,应当和解。若轻微肿胀疼痛且不化脓,是气血虚弱,应当补益并托毒外出。若漫肿不痛、或不化脓、或脓成但不溃破,是血气极度虚弱,应当峻补。若颜色黯黑且轻微肿痛、或脓成但不排出、或腐肉不溃烂,是阳气虚寒,应当温补。如果怀疑疮疡未溃破,就一概使用败毒药物,反而会损伤脾胃,不仅肿胀不能化脓溃破,即使已溃破也难以收敛,导致七恶证候蜂拥而至,大多导致无法救治。经文说:各种疼痛、瘙痒、疮疡,都属于心火。若出现红肿烦躁、发热喜冷、便秘口渴、脉象洪数实,这是正常情况。即使在严寒季节,也必须使用大苦寒的药物,以泻除热毒。若脉象微弱、皮肤寒冷、腹泻痢疾、肠鸣、饮食不进、呕吐频繁、手足逆冷,这是反常情况。即使在盛夏季节,也必须使用大辛温的药物,以助长阳气。经文说:用寒凉药要避开寒季,用温热药要避开热季。若有假象则相反,即使违背季节规律,也必须顺从症状治疗。
痈疽,重按才痛的,病位深;轻按就痛的,病位浅。按压后凹陷不复原的,没有脓;按压后即刻复原的,有脓。凹陷不复原的可以消散。若按压时整体僵硬牵强,没有脓;按压时一半软一半硬的,有脓。又用手按压上下都不热的,没有脓;若局部很热的,有脓。凡是感觉有脓,应当立即刺破排脓。若无脓只是气肿,若有瘀血,务必谨慎!不可针刺破溃。
痈,体积大且高起,属于阳证,由六腑之气所生。疽,平坦且深陷于内,属于阴证,由五脏之气所成。
凡痈疽未破溃时,毒邪攻冲脏腑,一毫热性药物都不敢使用。若已破溃,脏腑已经亏损,饮食减少,一毫寒凉药物都不敢使用。
肿疡,指痈疽尚未见脓而肿胀的阶段。肿疡内外皆壅滞,宜以解毒发散为主。若想使用大黄,必须审慎辨别其虚寒的根本原因。
痈疽初起之时宜用灸法。治疗痈疽发背初生,屡试屡效。凡人初觉痈疽发背,无论是否已成形,只要红热肿痛,先用湿纸覆盖在上面,立刻观察,等待纸张先干燥的地方就是疽头所在。取大蒜切成片,厚度如三个铜钱叠起,放在疽头上,用火艾炷灸三壮,换一片蒜片。痛的,灸到不痛为止;不痛的,灸到感到痛时才停止。最重要的是早发现早灸为上策;刚发作一两天,十次灸治十次痊愈;三四天,六七次痊愈;五六天,三四次痊愈;过了七天,就不能再灸了。若有十几个头聚在一起生长,将大蒜捣成膏做成饼状,铺在疮头上,聚集艾火烧灼,也能安定病情。若背上初发红肿,里面有一颗黄如粟米大小的颗粒,就用独蒜切片如前法灸治,第二天去掉痂皮,脓自然溃破。
竹筒吸毒方 治疗各种恶疮。
用苦竹一节长约一二寸,选用竹节处最好,刮去青皮,薄如纸为佳,大小随疮口斟酌,应在毒疮初发时使用:
白蒺藜 苍术 乌药 白浓朴(各五钱)
以上四味药材锉成片,用水一碗,同煮竹筒,煎煮至药液将干为度。
趁竹筒热时,用手按在疮上,片刻之后,竹筒会自动粘在疮上,不必用手按住。再用前面的药量重新煮,等前面的竹筒冷却,用手拔下,再换热的,如前法操作,脓液自然被吸入筒中而愈。
荆芥败毒散 治疗痈疽疔肿、发背乳痈等症,憎寒壮热,严重的头痛拘急,症状像伤寒,发病一二日至四五日,服用一二剂可散其毒。轻症的,内部自行消散。
防风 荆芥 羌活 独活 柴胡 前胡 薄荷 连翘 桔梗 枳壳 川芎 茯苓 金银花 甘草 大便不通加大黄、芒硝,热甚痛急加黄芩、黄连。
以上药材锉碎,生姜煎服。疮在上部,饭后服;在下部,饭前服。
千金漏芦汤 治疗一切恶疮肿毒、丹瘤瘰疡、疔肿鱼睛、五发瘭疽。初起一两天,便如伤寒,头痛烦渴、拘急恶寒、肢体疼痛、四肢沉重、恍惚闷乱、坐卧不宁、皮肤壮热、大便闭结、小便赤黄等均治。孕妇勿用。
漏芦 白蔹 黄芩 麻黄 枳实(麸炒) 升麻 芍药 甘草(炙) 大黄 芒硝 连翘。
以上药材锉碎为一剂,水煎服。
追风通气散 治疗痈疽发背、脑疽流注、肿毒、救坏病、活死肌,防患于未然,根治于既愈之后。此药顺气匀血,扶植胃本,不伤元气,涤荡邪秽,自然通顺,不生变症,兼治打破伤折、疝气、香港脚、诸气痞塞、块痛腰痛,一切痰饮为患。
当归 何首乌(不犯铁器) 木通(去皮节) 赤芍 白芷 乌药 小茴香 枳壳(麸炒) 甘草
以上药材锉碎为一剂,酒、水各半煎。病在上部,饭后服;在下部,饭前服。
一、痈疽初萌,必由气血凝滞所致,日子久了,则血积于局部,滞而后盛发作,所以病患气血盛者应减少当归用量,多了则生血,会在别处再结痈毒,生生不绝。
一、痈疽发背在上部的,去掉木通,恐怕引导虚损下行,造成上盛下虚的病,难以用药。
一、痈疽生痰有两种:一是胃寒生痰,加半夏健脾化痰;二是郁而成风痰,加桔梗、生姜。
一、流注,可加独活。流注者,气血凝滞,故气滞则血留而凝。加独活者,可以动一身血脉,血脉既动,岂复有流注乎?(一方用醋湿纸贴痛处,以炒盐熨之即消。)
一、流注起于伤寒,伤寒表未尽,遗毒于四肢经络,涩于所滞而后为流注也。如病尚有潮热,则里有寒而未尽散,加升麻、苏叶;热不退、加干葛;头痛加川芎、姜、葱;无汗用酒、水各半煎,大能行血生气故也。
一、发背既久不愈,乃前医用凉药过也。凉药内伤其脾,外冰其血。脾主肌肉,脾既受伤,饮食必减,颜色痿瘁,肌肉不生;血为脉络,血一受冰,则气不旺,肌肉糜烂。故必理脾,脾健肉自生。本方去木通,少用当归,加浓朴、陈皮;盛则加白豆蔻。
一、凡病痈疽之人,有泄泻者,不可便服此药。宜先服蜡矾丸止泻,后用此。
一、肠肚内痈,宜十宣散与此方相间服之,并宜加忍冬藤。
一、肿毒坚硬不穿加川芎、独活、麻黄、连须葱煎服,出汗即穿。
一、伤折在头上去木通,加川芎、陈皮。
一、经年腰痛加萆薢、玄胡索,酒煎。
一、香港脚加木瓜、槟榔、穿山甲、水煎。
一、痰饮为患,或喘或咳或晕、头痛睛疼、遍身拘急、骨节痹疼、胸背头项腋胯腰腿手足聚结肿硬,或痛或不痛,按之无血潮,虽或有微红亦淡薄不热;坚如石,破之无脓,或有薄血、或清水、或乳汁;又有坏肉如破絮;或又如瘰疬在皮肉之间如鸡卵,可移动,软活不硬,破之亦无脓血,针口肉突出,唯觉咽喉痰实结塞,作寒作热加南星、半夏。
神功散 治疗痈疽发背、一切疔毒并瘰疬等症,已成未成患者神效。
川乌(泡去皮尖) 川黄柏(炙去粗皮,各等分)
以上研为细末,用唾液调成膏。如唾液少,漱口水亦可,发背痈疽等疮才起者,敷患处留顶。候药干,用淘米水时常润湿。每日药敷一次。如疮已成重患将溃烂者,先将槐枝、艾叶煎汤顿温,将疮洗净,用绢帛展去脓血,以香油润患处,用绵纸仍照患处剪成圆钱留顶粘贴,后用药涂于纸,如干,根据前用淘米水润。日换一次,听其自然流脓,不可手挤。如敷药后,病患疮觉住痛,减热即愈。如生肌,则腐肉自落。腐如不落者,剪割亦可,最不宜用针。发背不宜贴膏药。凡医疮,屏去别医,止饮别药方可治。忌气怒、房事、劳复并孝服体气,饮酒之人,饮食忌酒,并鸡、羊、鱼、肉、瓜茄、姜辣之物。若因气怒,再复发肿,根据前治之。如治对口并脑疽,不必洗去旧药,逐次添药,恐动疮口惹风也。一肿毒加南星、赤小豆等分,醋调涂即消,姜汁亦可。
真人夺命饮 治疗一切痈疽疔肿,不问阴阳虚实善恶,肿溃大痛或不痛。然当服于未溃之先与初溃之际。如毒已失溃不可服。仍用一剂,大势已退,然后随症调治,其功甚捷,诚仙方也。
穿山甲(三大片,切,蛤粉炒成珠) 天花粉 甘草节 乳香(明透者) 赤芍 白芷(各一钱)
防风 贝母(各七分) 没药 皂角刺(各五分,炒) 陈皮(一钱半) 归尾(一钱半) 金银花(二钱)
以上锉一剂,好酒煎,空心、热服。能饮者,服后再饮酒三五杯,滓再煎服。在背俞,倍皂角刺;在腹膜,倍白芷;在胸次,加栝蒌仁(二钱);在四肢,倍金银花。
吕洞宾仙传化毒汤 治疗痈疽、发背、乳痈、一切无名肿毒。初起服之立消。已成已溃服之立愈。
防风 甘草节 白芷 茯苓 贝母 黄芩 连翘 白芍(各一钱) 天花粉 金银花(各一钱二分)
半夏(七分) 乳香 没药(各五分)
以上锉一剂,好酒煎。胸前,饭前服;背上,饭后服;下部,空心;上部;食后。俱要出汗为度。如无汗,用木香熏脚膝腕内,被盖汗出而愈。
神仙排脓散 治疗恶疮毒、风毒、疔疮、背花疮、小儿恶疮,脓血俱从大便中出。亦治气滞腹胀及妇人经闭不通。此方,壮实之人可用,虚弱者当忌之矣。
大黄(十二两,酒浸一宿晒干) 白芷 沉香 木香 乳香 没药 穿山甲(陈壁土炒。各五钱)
以上各为细末,量人虚实用之。实者不过三钱,虚者二钱半。临卧,用好生酒调服。服后,禁饮食汤水半日。五更觉腹内疼痛,动三五次,以稀米粥补之。服此药内有穿山甲,恐令人作呕,须慎之,即嚼生葱可止。凡修合此药要诚意,不可令妇人、鸡犬见,又不可多合,恐久放则不效矣。
芙蓉膏 治疗痈疽发背诸毒。
芙蓉叶(或皮或根亦可) 黄荆子
以上各等分,入石臼内捣极烂,用鸡子清调,搽于疮上留顶,不过二次收功。顶如烟起,立时止痛。其效如神。
一方 治疗发背痈疽,不问已溃未溃,敷上立消,止痛如神。
白金凤花科,连根叶同捣烂。先用陈米醋洗净患处,后敷药,一日一换。疮将好,用桑叶醋煮一滚即捞起贴疮上,即生肌收口而愈。
溃疡者,痈疽之脓已溃出也。疡溃,内外皆虚,宜以补接为主。设欲行香散者,宜防其虚实之失。
由是言之,则痈疽之肿时与溃时不同。
痈疽已溃之后,宜后方。(李氏云:疽疾将安,每日当服十全大补汤以补气血,宜与千金内托散相间服。)
托里消毒饮 治疗一切痈疽六七日未消者。服此药,疮未成即消,已成即溃,能壮气血、固脾胃,使毒瓦斯不能内攻,使毒脓易溃、肌肉易生。切不可早用生肌之药,恐毒未尽反溃烂难愈。
金银花(三钱) 黄芪(蜜水炒) 天花粉(各二钱) 防风 当归(酒洗) 川芎 白芷
浓朴(姜汁炒) 桔梗 穿山甲(炒成珠) 皂角刺(炒。各一钱) 陈皮(三钱)
以上锉一剂,酒、水各一盏煎服。疮在上,食后服;在下,空心服。后用水煎服。
千金内托散 治疗痈疽疮疖,未成者速败,已成者速溃,脓自去,不用手挤;恶肉自去,不用刀针。
服药后,疼痛顿解,此药活血匀气,调胃补虚、祛风邪、辟秽气,乃王道之剂。宜多服之大效。
黄芪(蜜炙) 人参 当归(酒洗各二钱) 川芎 防风 桔梗 白芷 浓朴(姜汁炒) 薄荷
甘草(生用。各一钱) 加金银花亦可。
以上为细末,每服二钱,黄酒调下。不饮酒,木香汤调下亦可。或都作一剂,用酒煎尤佳。痈疽肿痛,倍白芷;不肿痛,倍官桂,不进饮食加砂仁、香附;痛甚加乳香、没药;水不干加知母、贝母;疮不穿、加皂角刺;咳加半夏、陈皮、杏仁、生姜五片;大便闭加大黄、枳壳;小便涩加麦门冬、车前子、木通、灯草。
十全大补汤 治疗痈疽溃后,补气血、进饮食,实为切要。凡脓血出多,阴阳两虚,此药有回生起死之功。但不分经络,不载时令,医者触类而长之可也。或见肿平痛宽,遂以为安。慢不知者无补调养之功,愈后虚证复见,因而转为他病而危剧者多矣。
神仙蜡矾丸 治疗痈疽及肺痈、肠痈,能消毒、固脏腑、止疼痛、护脂膜、止泻漏,化脓痈疽溃后宜。兼治诸疮毒、粉瘤、痰核,三五年者,半料即消。不问恶疮新起者亦效。
黄蜡(二两) 白矾(三两)
以上为末,熔蜡为丸,如梧桐子大。每服三十九,酒下。不饮酒,熟水下。一日服三次。肺痈,蜜汤下。咳嗽,姜汤下。
五善七恶主治:夫善者,动息自宁,饮食知味、便利调匀、脓溃肿消、水鲜不臭、神彩精明、语声清朗、体气和平是也。此属腑症,病微邪浅,更能慎起居、节饮食,勿药自愈。恶者,乃五脏亏损之症。或因汗下失宜,荣卫消灼;或因寒凉克伐,气血不足,或因峻厉之剂,胃气受伤,以致真气虚而邪气实,外似有余而内实不足。法当纯补胃气,多有可生。不可因其恶遂弃而不治。
若大渴发热,或泻泄淋闭者,邪火内淫,一恶也。(竹叶黄芪汤。气血俱虚,八珍汤加黄芪、麦门冬、五味子、山茱萸,如不应,佐以加减八味丸同服)
若脓血既泄,肿痛尤甚,脓色败臭者,胃气虚而火盛,二恶也。(人参黄芪汤。)如不应,用十全大补汤加麦门、五味。)
若目视不正、黑睛紧小、白睛青赤、瞳子上视者,肝肾阴虚而目系急,三恶也。
(六味丸加炒山栀、麦冬、五味子。如不应,用八珍汤加炒山栀、麦冬、五味子。)
若喘粗气短、恍惚嗜卧者,脾肺虚火,四恶也。(六君子加大枣、生姜。如不应,用补中益气
Pulse: The pulse in carbuncles and sores (Carbuncle and sore) is typically rapid. A floating pulse indicates Yang, while a sinking pulse indicates Yin. If the pulse is floating and rapid but there is no heat sensation on the surface, only aversion to cold is present. If the painful area can be identified, moxibustion or acupuncture should be applied urgently. If the pulse is surging and rapid, the disease is progressing, and pus formation is imminent.
If the pulse is slippery, full, tight, or hurried, internal resolution is possible, preventing ulceration. For treatments suitable for supporting the interior (Supporting the interior), the pulse should be deficient, soft, or slow. Alternatively, a knotted, choppy, or faint pulse also warrants such treatment after ulceration. A long and moderate pulse indicates easy treatability, whereas a short and scattered pulse indicates critical danger. The appearance of knotted, hurried, or intermittent pulses signifies certain death.
In treating sores and ulcers (Sores and ulcers), one must observe the transmission through meridians, distinguish between exterior and interior syndromes, and assess the patient's deficiency or excess to determine whether to attack or tonify. For instance, if swelling, pain, heat, thirst, and constipation are present, the pathogen is internal, and unblocking methods should be used. If swelling with pain, alternating chills and fever, and headache occur, the pathogen is external, and dispersing methods should be employed. If swelling and pain are severe, the pathogen is in the meridians, and harmonizing methods are appropriate. If there is slight swelling and pain without pus formation, Qi and Blood are deficient, and tonifying support (Tonifying support) is indicated. If there is diffuse swelling without pain, or failure to form pus, or failure of formed pus to discharge, Qi and Blood are severely deficient, requiring strong tonification. If the lesion is dark purple with slight swelling/pain, or pus fails to discharge/corrupt flesh fails to slough, Yang Qi is deficient and cold, necessitating warming tonification. If one suspects non-ulceration and indiscriminately uses detoxifying herbs, it may damage the Spleen and Stomach, preventing pus formation and discharge, leading to the onset of "Seven Evils" (Seven evils), often resulting in untreatable conditions. The Classics state: "All pain, itching, and sores belong to Heart Fire." If redness, swelling, irritability, fever preferring cold, constipation, thirst, and a surging-rapid-full pulse are present, this is the normal presentation. Even in severe cold, bitter-cold herbs must be used to drain heat and toxicity. If the pulse is faint, skin is cold, diarrhea/dysentery occurs, bowel sounds are audible, food intake is poor, vomiting is frequent, and extremities are cold, this is an abnormal presentation. Even in peak summer, pungent-warm herbs must be used to assist Yang Qi. The Classics say: "Use cold herbs avoiding cold seasons; use warm herbs avoiding warm seasons." However, if false signs are present, reverse this rule; despite violating seasonal norms, follow the syndrome.
For carbuncles and sores, pain only upon deep pressure indicates a deep pathology; pain upon light pressure indicates superficial pathology. Indentation that does not rebound immediately suggests absence of pus; immediate rebound suggests presence of pus. Non-rebounding areas can be resolved. Uniform hardness upon pressure suggests no pus; semi-softness in the center suggests pus. Lack of heat upon palpation suggests no pus; significant heat suggests pus. Once pus is suspected, it must be drained immediately. If there is only Qi swelling without pus, or presence of blood, extreme caution is required; do not puncture.
A carbuncle (Carbuncle) is large, elevated, and belongs to Yang, generated by the Qi of the Six Fu Organs. A疽 (Jú - a type of deep-seated abscess) is flat, deep-seated, and belongs to Yin, formed by the Qi of the Five Zang Organs.
Before ulceration, when toxins attack the Zang-Fu, hot herbs must not be used. After ulceration, when Zang-Fu are depleted and appetite is low, cold herbs must not be used.
"Swelling before ulceration" (Pre-ulcerative swelling) refers to swelling before pus appears. With internal and external stagnation, the primary treatment is to dissipate toxicity and release the exterior. If using Rhubarb (Rhei Radix et Rhizoma), carefully examine the root cause of deficiency and cold.
Moxibustion for early-stage carbuncles and sores: Treating initial back carbuncles has proven effective repeatedly. Upon initial sensation of a back carbuncle, regardless of whether it has formed a nodule, if red, hot, swollen, and painful, cover the area with wet paper. Observe immediately; the first spot where the paper dries indicates the head of the abscess. Place a slice of garlic (thickness of three stacked coins) on the head and apply three moxa cones. Replace garlic as needed. If painful, moxa until pain ceases; if painless, moxa until pain is felt. Early detection and treatment are crucial: treated within 1-2 days, 10/10 heal; 3-4 days, 6-7/10 heal; 5-6 days, 3-4/10 heal; after 7 days, moxibustion is ineffective. For multiple heads, mash garlic into a paste, apply as a cake, and burn moxa over it. For a single yellow grain-like nodule on an initially red/swollen back, use single garlic slice moxibustion; scab falls next day, pus discharges naturally.
Bamboo Tube Suction Method: Treats various malignant sores.
Take a section of bitter bamboo (1-2 cun), preferably at the node, scrape off green skin until thin as paper. Size depends on the sore. Used for initial toxic sores:
Tribulus Fruit (Tribuli Fructus), Atractylodes Rhizome (Atractylodis Rhizoma), Lindera Root (Linderae Radix), Magnolia Bark (Magnoliae Cortex) (each 5 qian).
Chop these four ingredients, add one bowl of water, and boil together with the bamboo tube until the liquid is nearly dry.
While the bamboo tube is hot, press it onto the sore. It will adhere automatically. Re-boil the herbs, replace the cooled tube with a hot one, and repeat. Pus will be sucked into the tube.
Jingjie Baidu San: Treats carbuncles, sores, furuncles, back carbuncles, breast abscesses, with aversion to cold and high fever, severe headache and stiffness, resembling Taiyang disease. Within 1-4 days, 1-2 doses dissipate toxicity. Mild cases resolve internally.
Saposhnikovia Root (Saposhnikoviae Radix), Schizonepeta Spike (Schizonepetae Spica), Notopterygium Rhizome (Notopterygii Rhizoma), Angelica Pubescens Root (Pubescent Angelicae Radix), Bupleurum Root (Bupleuri Radix), Peucedanum Root (Peucedani Radix), Mint Herb (Menthae Haplocalycis Herba), Forsythia Fruit (Forsythiae Fructus), Platycodon Root (Platycodi Radix), Aurantium Fruit (Aurantii Fructus), Ligusticum Rhizome (Ligustici Chuanxiong Rhizoma), Poria (Poria), Honeysuckle Flower (Lonicerae Japonicae Flos), Licorice Root (Glycyrrhizae Radix et Rhizoma). Add Rhubarb (Rhei Radix et Rhizoma) and Mirabilite (Natrii Sulfas) for constipation; add Scutellaria Root (Scutellariae Radix) and Coptis Rhizome (Coptidis Rhizoma) for severe heat/pain.
Chop, decoct with fresh ginger. Take after meals for upper body sores; before meals for lower body sores.
Qianjin Loulu Tang: Treats all malignant sores, swelling/toxicity, erysipelas, scrofula, furuncles, fish-eye sores, and five-type carbuncles. Initial 1-2 days present like Taiyang disease: headache, irritability/thirst, stiffness/aversion to cold, limb pain/heaviness, mental confusion/restlessness, skin heat, constipation, dark yellow urine. Contraindicated in pregnancy.
Loulu Root (Euphorbiae Humifusae Radix), Ampelopsis Rhizome (Ampelopsis Rhizoma), Scutellaria Root (Scutellariae Radix), Ephedra Stem (Ephedrae Herba), Aurantium Fruit (Aurantii Fructus, bran-fried), Cimicifuga Rhizome (Cimicifugae Rhizoma), Peony Root (Paeoniae Radix), Licorice Root (Glycyrrhizae Radix et Rhizoma, honey-fried), Rhubarb (Rhei Radix et Rhizoma), Mirabilite (Natrii Sulfas), Forsythia Fruit (Forsythiae Fructus).
Chop, decoct in water.
Zhuifeng Tongqi San: Treats back carbuncles, neck carbuncles, flowing deposits, swelling/toxicity,挽救坏病 (saving critical conditions), revitalizing dead tissue. Prevents disaster before onset, removes roots after healing. Regulates Qi and Blood, supports Stomach root, does not damage Yuan Qi, clears turbidity, ensures smooth flow, prevents complications. Also treats trauma/fractures, hernias, gout, Qi stagnation, masses/back pain, and Phlegm-fluid retention.
Angelica Sinensis Root (Angelicae Sinensis Radix), Polygonum Multiflorum Root (Polygoni Multiflori Radix, avoid iron), Akebia Stem (Akebiae Caulis, remove nodes), Red Peony Root (Paeoniae Radix Rubra), Angelica Dahurica Root (Angelicae Dahuricae Radix), Lindera Root (Linderae Radix), Fennel Seed (Foeniculi Fructus), Aurantium Fruit (Aurantii Fructus, bran-fried), Licorice Root (Glycyrrhizae Radix et Rhizoma).
Chop, decoct with equal parts wine and water. Upper body: after meals; Lower body: before meals.
Notes on modifications:
1. For early carbuncles caused by Qi/Blood stagnation, reduce Angelica if Qi/Blood is abundant to prevent new sores elsewhere.
2. For upper back carbuncles, remove Akebia to avoid draining deficiency downward.
3. Phlegm generation: Cold-Stomach phlegm adds Pinellia Tuber (Pinelliae Rhizoma); Wind-Phlegm from depression adds Platycodon Root (Platycodi Radix) and Ginger (Zingiberis Rhizoma Recens).
4. Flowing deposits (Liuzhu): Add Saposhnikovia Root (Saposhnikoviae Radix) to move Blood/Qi. Alternative: Vinegar-moistened paper + roasted salt compress.
5. Flowing deposits originating from unresolved Taiyang disease: Add Cimicifuga Rhizome (Cimicifugae Rhizoma) and Perilla Leaf (Perillae Folium) for tidal fever; Kudzu Root (Puerariae Lobatae Radix) for persistent heat; Ligusticum Rhizome (Ligustici Chuanxiong Rhizoma), Ginger, Scallion for headache; Wine/Water half-half for anhidrosis.
6. Chronic non-healing back carbuncles due to excessive cold herbs: Stop cold herbs, strengthen Spleen. Remove Akebia, reduce Angelica, add Magnolia Bark (Magnoliae Cortex) and Tangerine Peel (Citri Reticulatae Pericarpium); add Cardamom (Cardamomi Fructus) if excess.
7. For patients with diarrhea, take Wax-Alum Pill (Shenxian Lafan Wan) first to stop diarrhea.
8. Internal intestinal abscesses: Alternate with Shixuan San, add Honeysuckle Stem (Lonicerae Japonicae Caulis).
9. Hard swelling not rupturing: Add Ligusticum Rhizome, Saposhnikovia Root, Ephedra Stem, Scallion (with roots), decoct in wine/water to induce sweating and rupture.
10. Head trauma: Remove Akebia, add Ligusticum Rhizome, Tangerine Peel.
11. Chronic back pain: Add Dioscorea Hypoglauca Rhizome (Dioscoreae Hypoglaucae Rhizoma) and Corydalis Rhizome (Corydalidis Rhizoma), decoct in wine.
12. Gout: Add Quince (Chaenomelis Fructus), Betel Nut (Arecae Semen), Pangolin Scales (Manis Squama), decoct in water.
13. Phlegm-fluid disorders: For wheezing/cough/dizziness/headache/eye pain/stiffness/joint pain/swelling/hardness (stone-like, no pus, clear fluid/milk-like, or rotten flesh-like wadding/scrofula-like movable lumps): Add Arisaema Rhizome (Arisaematis Rhizoma) and Pinellia Tuber (Pinelliae Rhizoma) for chills/fever/phlegm obstruction.
Shengong San: Highly effective for back carbuncles, all furuncles, and scrofula, whether formed or unformed.
Sichuan Aconite Root (Aconiti Lateralis Radix Praeparata, soaked, peeled, de-eyed), Phellodendron Bark (Phellodendri Chinensis Cortex, honey-fried, coarse skin removed) (equal parts).
Grind to fine powder, mix with saliva to form paste. Apply to lesion, leaving the top open. Keep moist with rice-washing water. Apply once daily. For severe impending ulceration: Wash with boiling water decoction of Locust Twig (Gleditsiae Sinensis Spina) and Mugwort Leaf (Artemisiae Argyi Folium), wipe pus/blood with silk, moisturize with sesame oil, apply cotton paper cut to shape (leaving top open), spread medicine on paper. Change daily. Do not squeeze. Pain/heat cessation indicates healing. Sloughing necrotic tissue follows granulation. If slough persists, surgical removal is acceptable; needles are contraindicated. Avoid plasters on back carbuncles. Isolate patient from other doctors/medications. Avoid anger, sexual activity, overwork, mourning attire odors. Drinkers must avoid alcohol. Diet excludes chicken, mutton, fish, meat, melons, eggplants, ginger, spicy foods. Relapse due to anger requires re-treatment. For occipital/carotid artery carbuncles, do not wash off old medicine; add gradually to avoid wind invasion. For general swelling, add Arisaema Rhizome (Arisaematis Rhizoma) and Adzuki Bean (Vigna Angularis Semen) equal parts, mix with vinegar or ginger juice.
Zhenren Duoming Yin: Treats all carbuncles, sores, furuncles, regardless of Yin/Yang, deficiency/excess, or good/bad prognosis, whether swollen/ulcerated, painful/painless. Administer before ulceration or at initial ulceration. Contraindicated if toxin has already dispersed. One dose reduces major symptoms, then adjust based on syndrome.
Pangolin Scales (Manis Squama, 3 large slices, cut, fried in clam powder until pearl-like), Trichosanthes Root (Trichosanthis Radix), Licorice Node (Glycyrrhizae Radix et Rhizoma nodus), Frankincense Resin (Boswelliae Resina, transparent), Red Peony Root (Paeoniae Radix Rubra), Angelica Dahurica Root (Angelicae Dahuricae Radix) (each 1 qian).
Saposhnikovia Root (Saposhnikoviae Radix), Fritillaria Bulb (Fritillariae Cirrhosae Bulbus) (each 7 fen), Myrrh Resin (Myrrha), Gleditsia Spine (Gleditsiae Sinensis Spina, fried) (each 5 fen), Tangerine Peel (Citri Reticulatae Pericarpium) (1.5 qian), Angelica Sinensis Tail (Angelicae Sinensis Radix cauda) (1.5 qian), Honeysuckle Flower (Lonicerae Japonicae Flos) (2 qian).
Chop, decoct in good wine. Take on empty stomach, warm. Heavy drinkers may take 3-5 cups of wine after medication, then decoct residue again. Increase Gleditsia Spine for back acupoints; increase Angelica Dahurica for abdominal membrane; add Trichosanthes Kernel (Trichosanthis Semen) for chest; increase Honeysuckle Flower for limbs.
Lü Dongbin Xianchuan Huadu Tang: Treats carbuncles, back carbuncles, breast abscesses, all unnamed swellings/toxicity. Eliminates immediately if taken at onset; heals immediately if taken after formation/ulceration.
Saposhnikovia Root (Saposhnikoviae Radix), Licorice Node (Glycyrrhizae Radix et Rhizoma nodus), Angelica Dahurica Root (Angelicae Dahuricae Radix), Poria (Poria), Fritillaria Bulb (Fritillariae Cirrhosae Bulbus), Scutellaria Root (Scutellariae Radix), Forsythia Fruit (Forsythiae Fructus), White Peony Root (Paeoniae Radix Alba) (each 1 qian), Trichosanthes Root (Trichosanthis Radix), Honeysuckle Flower (Lonicerae Japonicae Flos) (each 1.2 qian), Pinellia Tuber (Pinelliae Rhizoma) (7 fen), Frankincense Resin (Boswelliae Resina), Myrrh Resin (Myrrha) (each 5 fen).
Chop, decoct in good wine. Chest: before meals; Back: after meals; Lower body: empty stomach; Upper body: after meals. Goal is sweating. If no sweat, fumigate feet/knees/wrists with Costus Root (Saussureae Radix), cover to induce sweat.
Shenxian Paimao San: Treats malignant sores, wind-toxicity, furuncles, back flower sores, pediatric malignant sores. Pus/blood discharged via stool. Also treats Qi stagnation abdominal distension and amenorrhea. Suitable for robust individuals; contraindicated for weak persons.
Rhubarb (Rhei Radix et Rhizoma, 12 liang, soaked in wine overnight, dried), Angelica Dahurica Root (Angelicae Dahuricae Radix), Agarwood (Aquilariae Lignum Resinatum), Aucklandia Root (Aucklandiae Radix), Frankincense Resin (Boswelliae Resina), Myrrh Resin (Myrrha), Pangolin Scales (Manis Squama, fried in old wall soil) (each 5 qian).
Grind each separately to fine powder. Dose according to deficiency/excess: Robust ≤3 qian; Weak 2.5 qian. Mix with raw wine before bed. Fast for half day. Expect abdominal pain and 3-5 bowel movements at dawn; replenish with thin rice porridge. If nausea occurs due to Pangolin Scales, chew raw scallion. Prepare with sincerity; keep away from women/chickens/dogs. Do not prepare large quantities for long storage as efficacy diminishes.
Furong Gao: Treats carbuncles, back carbuncles, various toxins.
Hibiscus Leaf (Hibisci Mutabilis Folius) (or bark/root), Vitex Fruit (Viticis Fructus) (equal parts).
Pound extremely fine in mortar, mix with egg white, apply to sore leaving top open. Cure in ≤2 applications. Smoke-like vapor rising indicates instant pain relief. Effect is miraculous.
Another Formula: Treats back carbuncles, regardless of ulceration status. Eliminates instantly, stops pain miraculously.
White Platinum Phoenix Flower (Browallia americana? Note: Likely local herb name), pound whole plant including roots/leaves. Clean lesion with aged rice vinegar, apply medicine, change daily. Near healing, boil mulberry leaves in vinegar, apply warm to promote granulation/closure.
Ulceration (Ulceration) means pus has discharged from carbuncles/sores. Both interior and exterior are deficient; primary treatment is tonification and connection. If using aromatic dispersants, guard against deficiency/excess errors. Thus, swelling phase differs from ulceration phase.
Post-ulceration treatment follows later formulas. (Li Shi says: As疽 stabilizes, take Shiquan Dabu Decoction daily for Qi/Blood tonification, alternating with Qianjin Neituo San.)
Tuoli Xiaodu Yin: Treats carbuncles/sores not resolved after 6-7 days. Prevents formation, promotes discharge, strengthens Qi/Blood, secures Spleen/Stomach, prevents internal attack of toxins, facilitates pus discharge/granulation. Do not use granulation-promoting herbs early to avoid trapping toxins.
Honeysuckle Flower (Lonicerae Japonicae Flos, 3 qian), Astragalus Root (Astragali Radix, honey-fried), Trichosanthes Root (Trichosanthis Radix) (each 2 qian), Saposhnikovia Root (Saposhnikoviae Radix), Angelica Sinensis Root (Angelicae Sinensis Radix, wine-washed), Ligusticum Rhizome (Ligustici Chuanxiong Rhizoma), Angelica Dahurica Root (Angelicae Dahuricae Radix), Magnolia Bark (Magnoliae Cortex, ginger juice-fried), Platycodon Root (Platycodi Radix), Pangolin Scales (Manis Squama, fried to pearls), Gleditsia Spine (Gleditsiae Sinensis Spina, fried) (each 1 qian), Tangerine Peel (Citri Reticulatae Pericarpium, 3 qian).
Chop, decoct with 1 cup wine + 1 cup water. Upper body: after meals; Lower body: empty stomach, then decoct residue in water.
Qianjin Neituo San: Treats carbuncles/furuncles. Rapidly resolves unformed lesions, accelerates discharge of formed lesions. Pus drains spontaneously without squeezing; necrotic tissue sloughs without knives/needles. Relieves pain instantly. Regulates Blood/Qi, harmonizes Stomach, tonifies deficiency, dispels wind/turbidity. A "King's Way" formula. Effective with prolonged use.
Astragalus Root (Astragali Radix, honey-fried), Ginseng Root (Ginseng Radix), Angelica Sinensis Root (Angelicae Sinensis Radix, wine-washed, each 2 qian), Ligusticum Rhizome (Ligustici Chuanxiong Rhizoma), Saposhnikovia Root (Saposhnikoviae Radix), Platycodon Root (Platycodi Radix), Angelica Dahurica Root (Angelicae Dahuricae Radix), Magnolia Bark (Magnoliae Cortex, ginger juice-fried), Mint Herb (Menthae Haplocalycis Herba), Licorice Root (Glycyrrhizae Radix et Rhizoma, raw) (each 1 qian). Optional: Add Honeysuckle Flower.
Grind to powder. Take 2 qian with yellow wine. Non-drinkers: Costus Root Decoction (Saussureae Inflorescentia). Or decoct all as one dose in wine. Modifications: Carbuncle swelling/pain → double Angelica Dahurica; No swelling/pain → double Cinnamon Bark (Cinnamomi Cortex); Poor appetite → add Amomum Fruit (Amomi Fructus), Cyperus Rhizome (Cyperī Rhizoma); Severe pain → add Frankincense Resin (Boswelliae Resina), Myrrh Resin (Myrrha); Persistent drainage → add Anemarrhena Rhizome (Anemarrhenae Rhizoma), Fritillaria Bulb (Fritillariae Cirrhosae Bulbus); Non-puncturing → add Gleditsia Spine (Gleditsiae Sinensis Spina); Cough → add Pinellia Tuber (Pinelliae Rhizoma), Tangerine Peel (Citri Reticulatae Pericarpium), Apricot Seed (Armeniacae Semen Amarum), Ginger (5 slices); Constipation → add Rhubarb (Rhei Radix et Rhizoma), Aurantium Fruit (Aurantii Fructus); Dysuria → add Ophiopogon Tuber (Ophiopogonis Tuber), Plantago Seed (Plantaginis Semen), Akebia Stem (Akebiae Caulis), Juncus Effusus (Junci Medulla).
Shiquan Dabu Decoction: Post-ulceration, tonifies Qi/Blood, promotes appetite. Crucial for profuse pus/blood loss causing Yin/Yang dual deficiency. Has life-restoring power. Does not differentiate meridians/seasons; physicians must adapt. Beware mistaking reduced swelling/pain for cure; lack of proper post-recovery tonification leads to relapse/complications.
Shenxian Lafan Wan: Treats carbuncles, lung abscesses, intestinal abscesses. Detoxifies, stabilizes Zang-Fu, stops pain, protects fatty membranes, stops diarrhea/leakage. Suitable post-ulceration. Also treats sores, sebaceous cysts, phlegma nodules (3-5 years duration resolve with half dose). Effective for new malignant sores.
Beeswax (Apis Ceranae Cera, 2 liang), Alum (Alumen, 3 liang).
Grind, melt wax to make pills size of Sophora seeds. Take 39 pills with wine. Non-drinkers: boiled water. 3 times daily. Lung abscess: Honey water. Cough: Ginger water.
Five Goods and Seven Evils Management:
"Goods" (Good prognostic signs): Calm breathing/appetite, regular bowels/urination, pus discharge/swelling reduction, fresh/non-foul pus, bright spirit/clear voice, balanced constitution. Indicates Fu organ syndrome, mild pathogen/shallow location. Self-heals with lifestyle/diet regulation.
"Evals" (Evil prognostic signs): Zang organ depletion. Caused by improper sweating/purgation damaging Ying/Wei; cold herbs damaging Qi/Blood; harsh drugs injuring Stomach Qi. Result: True Qi deficiency, Pathogenic Excess. External appearance of excess, internal reality of deficiency. Treatment: Purely tonify Stomach Qi. Many survive. Do not abandon treatment.
1. Extreme thirst/fever, diarrhea/stranguria: Internal flaring of pathogenic fire. First Evil. (Zhuye Huangqi Tang. Qi/Blood dual deficiency: Bazhen Decoction + Astragalus Root (Astragali Radix), Ophiopogon Tuber (Ophiopogonis Tuber), Schisandra Fruit (Schisandrae Chinensis Fructus), Cornus Fruit (Corni Fructus). If ineffective, add Jiawei Bawei Wan.)
2. Post-drainage, severe swelling/pain, foul/discolored pus: Stomach Qi deficiency with flaming fire. Second Evil. (Ren Shen Huangqi Tang.) If ineffective, Shiquan Dabu Decoction + Ophiopogon Tuber, Schisandra Fruit.
3. Misaligned gaze, constricted pupil, blue/red sclera, upward-deviating pupil: Liver/Kidney Yin deficiency with tense eye tendons. Third Evil. (Liuwei Dihuang Wan + Fried Gardenia Fruit (Gardeniae Fructus), Ophiopogon Tuber (Ophiopogonis Tuber), Schisandra Fruit (Schisandrae Chinensis Fructus). If ineffective, Bazhen Decoction + Fried Gardenia Fruit, Ophiopogon Tuber, Schisandra Fruit.)
4. Rough breathing/shortness of breath, mental confusion/somnolence: Spleen/Lung deficiency fire. Fourth Evil. (Liujunzi Tang + Jujube Fruit (Zizyphi Fructus), Ginger (Zingiberis Rhizoma Recens). If ineffective, Buzhong Yiqi Tang...